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Preoperative pain neuroscience education for shoulder surgery: A case series

BACKGROUND: Central sensitisation, in addition to high levels of fear-avoidance and pain catastrophisation may exist in a subgroup of patients with shoulder pain. Pain neuroscience education (PNE) has been shown to positively influence sensitivity of the nervous system, as well as reduce fear and ca...

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Autores principales: Louw, Adriaan, Rico, Debra, Langerwerf, Leigh, Maiers, Nicholas, Diener, Ina, Cox, Terry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479411/
https://www.ncbi.nlm.nih.gov/pubmed/32935067
http://dx.doi.org/10.4102/sajp.v76i1.1417
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author Louw, Adriaan
Rico, Debra
Langerwerf, Leigh
Maiers, Nicholas
Diener, Ina
Cox, Terry
author_facet Louw, Adriaan
Rico, Debra
Langerwerf, Leigh
Maiers, Nicholas
Diener, Ina
Cox, Terry
author_sort Louw, Adriaan
collection PubMed
description BACKGROUND: Central sensitisation, in addition to high levels of fear-avoidance and pain catastrophisation may exist in a subgroup of patients with shoulder pain. Pain neuroscience education (PNE) has been shown to positively influence sensitivity of the nervous system, as well as reduce fear and catastrophisation prior to lumbar and total knee surgery. To date, no study has examined the application of PNE prior to shoulder surgery. OBJECTIVES: This study examined the response to preoperative PNE in patients preparing for shoulder surgery. METHOD: An exploratory pre–post case series was conducted. Twelve patients scheduled for surgery completed various pre-education measurements including shoulder pain, fear-avoidance, pain catastrophisation, beliefs and expectations regarding surgery, active shoulder flexion and pressure pain thresholds for the involved and uninvolved shoulder and the dominant-sided knee. Patients underwent a standard 30-min, one-on-one PNE session with a physiotherapist prior to surgery. RESULTS: Following education, all measures improved with some failing to reach significance: self-reported pain (p = 0.125), pain catastrophisation (p = 0.250) and pain pressure threshold of the uninvolved shoulder (p = 0.68) and knee (p = 0.097). Fear-avoidance (p = 0.013), active shoulder flexion (p = 0.013) and pain pressure threshold for the involved shoulder (p = 0.004) significantly improved. CONCLUSION: A small patient group improved beyond minimal detectable change and/or minimal clinical important difference after education. No significant shifts of the preoperative beliefs occurred after education. CLINICAL IMPLICATIONS: Preoperative PNE may be beneficial to a subgroup of patients scheduled for shoulder surgery.
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spelling pubmed-74794112020-09-14 Preoperative pain neuroscience education for shoulder surgery: A case series Louw, Adriaan Rico, Debra Langerwerf, Leigh Maiers, Nicholas Diener, Ina Cox, Terry S Afr J Physiother Original Research BACKGROUND: Central sensitisation, in addition to high levels of fear-avoidance and pain catastrophisation may exist in a subgroup of patients with shoulder pain. Pain neuroscience education (PNE) has been shown to positively influence sensitivity of the nervous system, as well as reduce fear and catastrophisation prior to lumbar and total knee surgery. To date, no study has examined the application of PNE prior to shoulder surgery. OBJECTIVES: This study examined the response to preoperative PNE in patients preparing for shoulder surgery. METHOD: An exploratory pre–post case series was conducted. Twelve patients scheduled for surgery completed various pre-education measurements including shoulder pain, fear-avoidance, pain catastrophisation, beliefs and expectations regarding surgery, active shoulder flexion and pressure pain thresholds for the involved and uninvolved shoulder and the dominant-sided knee. Patients underwent a standard 30-min, one-on-one PNE session with a physiotherapist prior to surgery. RESULTS: Following education, all measures improved with some failing to reach significance: self-reported pain (p = 0.125), pain catastrophisation (p = 0.250) and pain pressure threshold of the uninvolved shoulder (p = 0.68) and knee (p = 0.097). Fear-avoidance (p = 0.013), active shoulder flexion (p = 0.013) and pain pressure threshold for the involved shoulder (p = 0.004) significantly improved. CONCLUSION: A small patient group improved beyond minimal detectable change and/or minimal clinical important difference after education. No significant shifts of the preoperative beliefs occurred after education. CLINICAL IMPLICATIONS: Preoperative PNE may be beneficial to a subgroup of patients scheduled for shoulder surgery. AOSIS 2020-08-11 /pmc/articles/PMC7479411/ /pubmed/32935067 http://dx.doi.org/10.4102/sajp.v76i1.1417 Text en © 2020. The Authors https://creativecommons.org/licenses/by/4.0/ Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Original Research
Louw, Adriaan
Rico, Debra
Langerwerf, Leigh
Maiers, Nicholas
Diener, Ina
Cox, Terry
Preoperative pain neuroscience education for shoulder surgery: A case series
title Preoperative pain neuroscience education for shoulder surgery: A case series
title_full Preoperative pain neuroscience education for shoulder surgery: A case series
title_fullStr Preoperative pain neuroscience education for shoulder surgery: A case series
title_full_unstemmed Preoperative pain neuroscience education for shoulder surgery: A case series
title_short Preoperative pain neuroscience education for shoulder surgery: A case series
title_sort preoperative pain neuroscience education for shoulder surgery: a case series
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479411/
https://www.ncbi.nlm.nih.gov/pubmed/32935067
http://dx.doi.org/10.4102/sajp.v76i1.1417
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